Strategy for the Organization, Development and Promotion of Health Tourism in Cyprus
PURPOSE OF THE STUDY
The purpose of this study is to investigate the factors that are necessary in allowing Cyprus to establish itself as a popular destination for Health Traveller’s. The first part of this report focuses on the research and analysis surrounding the organization, development and promotion of Health Tourism, as well as the advantages that are being experienced by other countries worldwide. Following this, a complete strategy is presented for the integration of Health Tourism as an essential product of the Cypriot Market. The need to implement such a strategy is needed today more than ever due to the fact that the traditional touristic product consisting the “Sun and Sea” is experiencing a downturn. The effort surrounding the incorporation of such a strategy is not only expected to serve as a framework in which Cyprus will become a popular medical destination and therefore experience all the economic and social benefits associated with it, but will also increase the level of health services that are provided to the domestic citizens; a phenomenon that has been experienced by other countries.
Even though Cyprus is still at its early stages in terms of this industry, it does fulfill a number of important criteria that gives it the potential to succeed in capturing a segment of the market and establishing itself as a competitor. Factors such as its strategic location, Mediterranean climate, family culture, the significant and substantial investments that have been made within the public and private healthcare sector, the expertise of doctors and other healthcare professionals having studied and trained abroad, as well as the ability to speak the English language adequately are a few of these required prerequisites.
The ability of Cyprus to establish itself as a medical destination depends firstly on the structure of its healthcare system and secondly on the advantage it has over other countries that are tapping into the market. The fact that Cyprus is an already established and worthy tourist destination, internationally recognized, provides a significant advantage for the development of health tourism.
DEFINITION
Health Tourism is defined as the process in which patients embark on cross-border healthcare to improve or maintain their health through therapies aimed at prevention and diagnosis through the combination of vacation and health. It is the economic activity that integrates both the medical and the tourism sector as one product.
METHODOLOGY
Various sources were used to obtain information for this study in an attempt to gain an understanding of the current circumstance that is present within Cyprus, the benefits of health tourism that Cyprus can potentially experience from, as well as the challenges that are faced. Interviews were conducted and questionnaires were distributed to professionals both in the medical and tourism industry. Literature reviews and website portals were also used to fill in the gaps, especially in regards to obtaining fundamental statistics both on a European and global level.
A number of limitations of the study need to be highlighted. Firstly it is important to note that there are no solid statistics concerning health tourism in Cyprus despite efforts to collect them. However the questionnaires and interviews did offer enough data for a clear analysis to be formed. Secondly through the questionnaires it became apparent that there are diversities in the opinions concerning the value of health tourism, causing a challenge when it came to forming a strategy accepted by all stakeholders for the promotion of health tourism. There was also a lack of participation from the big private and public hospitals which can be accounted by lack of education and understanding of the value of health tourism but also because today these hospitals are presently working to a high capacity, using up all their human resources.
CURRENT GLOBAL SITUATION
The extensive methods in accessing information (especially via the internet), the ease of mobility into other countries, the rising educational levels and expectations of patients has generated new trends in the healthcare division whereby more than sixty countries have incorporated health tourism as a fundamental product of their national industry.
Countries such as India, Pakistan, Malaysia and Thailand have invested considerable amounts of money into their infrastructure to initiate projects, make improvement and upgrade their medical and travel facilities in an attempt to facilitate the arrival of health traveler’s.
In countries which are regarded today as medical destinations, health tourism has proven to act as a catalyst in reforming the economy and health of the country. There has been an increase in the inflow of foreign exchange with new employment opportunities being created in the healthcare industry as well as in other domains. Specifically in the hotel industry there has been an increase in overnight stays from those individuals travelling with the patients, and there has been a marked increase in the quality of services that are provided, benefited by and in the interest of the domestic patients.
Referring to Hungary as an example, health tourism has generated more than 368,000,000 Euros from which 147,000,000 has come specifically from Dentistry (Family Choice by NHS Year Book Ltd).
CURRENT SITUATION IN CYPRUS
A wide range of conclusions about the current situation within Cyprus are summarized below, which will consequently act as the basis for the proposed strategy:
· Cyprus has in recent years experienced continuous growth and improvement of services in the healthcare sector through the creation of both the Nicosia General Hospital as well as the development of modern and well-equipped medical facilities in the private domain. As a general observation, the public domain in regards to its public hospitals has failed to extend services to healthcare travelers. Big private hospitals have also followed this same trend whereby they have successfully enjoyed a very large percentage of the Cypriot market and as a result deplete their resources there. The experience has shown that it is the smaller private clinics and hospitals that are keener on attracting health travelers.
· Doctors are educated at advanced and reputable universities and institutions, achieving a high standard of education whilst maintaining valuable contacts with professionals abroad, thereby enhancing the trust and safety needed to attract healthcare travelers.
· The cost for treatment in comparison to other countries can act as an added incentive. Cyprus can attract healthcare travelers not only as a “cheaper destination” just as India has done for example, but can also be a destination representing ‘value for money’ whereby the money spent is proportional to the quality of the service that is received.
· Healthcare travelers have today a wide range of options in terms of the medical services that are offered within Cyprus. Cyprus has also shifted focus to alternative forms of treatment and has began to establish anti-ageing and rehabilitation centers, facilities directed at long term care coupled with the potential for the development of preventative medical services. This area is of great importance because in most cases it will require cooperation from the hotel industry, thus providing a significant advantage.
· The lack of a General Healthcare Scheme has caused many challenges for Cyprus. An example is seen in the use of the EU European ID card which currently can not be used to receive healthcare from the private clinics in Cyprus. The lack of a general healthcare scheme has also resulted in a lack of competition and incentives in the healthcare industry, causing the cost of several services and treatments in Cyprus to be relatively higher in comparison to other European countries. It also acts negatively for those interested abroad due to the fact that it is assumed that a patient moving outside the border of their country will receive treatment from service providers who are part of and regulated by a National Healthcare System. Being under such a system means that there is complete control regarding the quality of care that is being provided as well as ensuring that the cost of such services are determined by the State and based on specific criteria. Unfortunately this is not yet the case for Cyprus.
· The absence of accredited facilities (based on international standards from internationally recognized bodies) hampers any attempts to view Cyprus as a medical destination. Accreditation is vital to the health tourism sector for both individual healthcare travelers who primarily search for treatments and health services via the internet, as well as for insurance companies where patient safety is their priority. In such cases, it is important that confirmation of the quality and safety of the services that are offered are done so through third party and internationally recognized independent bodies.
EVALUATION OF INTERNATIONAL MARKET TRENDS AND THE PRIORITIES IN THE CASE FOR CYPRUS
The market for health tourism worldwide was estimated in 2008 to be around $20 billion, a value expected to surpass $40 billion over the next few years. The United Kingdom is one of the largest markets in terms of patients embarking on cross-border healthcare and is a great interest to Cyprus. More specifically the number of British patients travelling abroad for health purposes had increased by 300% between 2004 and 2007 to reach 100.000. Various factors that keep pushing this number to increase include the high cost and long waiting lists of certain health services in their country, improved quality of services in other countries, the ease in which the internet can be used as a mode of communication and the ease in which patients can travel to other countries for their healthcare.
Apart from the UK, it is also essential to approach other markets from which Cyprus gains many tourists such as Germany, Sweden, Norway and Russia. It must be ensured that Cyprus approaches each market individually with a degree of priority and personalization rather than tackling health tourism as a whole unit. Each country must therefore be classified by its market, the treatments that are demanded, as well as the factors that push patients to seek treatments elsewhere and use these factors to develop a tailored strategy.
When it comes to calculating the revenue received in regards to the Health Tourism market of Cyprus, we would like to make it clear that at this present time there are no indicators or statistics for Cyprus that help secure a sound conclusion concerning the revenue that has been experienced from health tourism. As a result it is risky to make an accurate estimation due to the high subjectivity and statistical errors that are present. However, upon following international practices and reports, and using the indicating value of 2.5% (i.e. 2.5% of the total tourists are health travelers), it can be estimated that the value of the health tourism industry is around 60-120 million Euros (the exact method for this calculation is explained in detail within the strategy)
specific HEALTHCARE SERVICES IN GREATER DEMAND BY FOREIGNERS
Within the research it was observed that specific tests, procedures and treatments in Cyprus are demanded more by foreigners such as plastic surgery, preventative treatments, diagnostic tests, artificial insemination, IVF and dentistry. For these treatments it is important that the advantages Cyprus has in comparison to other countries are enhanced, including the high quality of medical services provided, the low cost of therapy (compared to some of the markets), the excellent Mediterranean climate and the highly trained doctors practicing within Cyprus are all enhanced. The main competitive advantage of Cyprus in comparison to other markets however is the fact that the healthcare traveler can combine the therapy with vacation and leisure.
TABLE OF HEALTH TOURISM MARKETS IN TERMS OF PRIORITY
UK and Cypriot UK residents
· Diagnostic tests
(Check ups)
· ΙVF
· Dental
· Cosmetic Surgery
· Procedures with long waiting lists e.g. Hip Replacement
· Elderly Care / Israel
· IVF
· Elderly Care / Switzerland
· Preventative Therapies
· Diagnostic Tests
Russia
· Diagnostic Tests (Check ups)
· ΙVF
· Dental
· Cosmetic Surgery / Belgium
· Dental
· ΙVF
· Wellness Tourism e.g. Medical Spa
· Preventative Therapies / Hungary
· Preventative Therapies
Austria
· Diagnostic Tests (Check ups)
· Wellness Tourism e.g. Medical Spa / France
· Preventative Therapies
Sweden
· ΙVF
· Cosmetic Surgery
· Elderly Care
· Phototherapy / Italy
· ΙVF
· Dental / Holland
· Preventative Therapies
United Arab Emirates
· Microsurgical Interventions
· ΙVF
· Gynecological Procedures
· Diagnostic Tests / USA and Cypriots of the USA
· ΙVF
· Dental
· Cosmetic Surgery
Germany
· Wellness Tourism e.g. Medical SPA
· Cosmetic Surgery
· Elderly Care
· Preventative Treatment
COMPETITORS FOR CYPRUS AND THEIR ASSOCIATED BEST PRACTICES
Within the strategy we have presented data for each country as well as the trends that have been formed, some of which are discussed below:
Hungary:
In terms of the English market, Hungary is a competing medical destination for Cyprus in the fields of both dentistry and cosmetic surgery. The Health Organization of Hungary has placed great emphasis on the promotion and the development of health tourism within the country, with their medical centers and intermediaries providing marketing services.
Turkey:
Over the past few years Turkey has gained itself a dynamic role in the field of health tourism through the accreditation of a number of its hospitals, the establishment of modern medicine in its scope as well as the development of new and modernized medical centers. The Statistical Institute of Turkey noted that in 2009 there were 165,000 healthcare traveler’s coming into Turkey, which brought the country around 360 million dollars in revenue, a value which is projected to increase 25% per year.
Greece:
The health tourism industry of Greece has enormous growth potential, especially in respect to the island of Crete. As a result Greece has restricted its promotion to wellness tourism whereby German Tour Operators specializing in health tourism, have already included Crete resorts into their programs. The legal framework in respect to thermal tourism is already being advanced, whilst procedures such as correcting myopia, cosmetic surgery, IVF, dialysis and obesity are all medical services that have started to become incorporated into Greece’s medical centers (e.g. Thessaloniki and Rhodes).